Introduction to Vascular Surgery

  Vascular surgery refers to all vascular diseases other than cardiovascular diseases. It includes diseases of three systems: arterial, venous and lymphatic.  Common arterial diseases include: arterial stenosis and occlusion caused by atherosclerotic plaque and thrombus, such as atherosclerotic occlusive disease (carotid artery, vertebral artery, renal artery, limb artery, etc.), arterial embolism; arterial inflammation, such as multiple aortitis, thrombo-occlusive vasculitis, nodular arteritis; arterial dilatation lesions, such as aneurysm; peripheral arterial dysfunction, such as Raynaud’s disease (phenomenon), erythema limb pain External pressure lesions, such as thoracic outlet syndrome, arterial compression syndrome, diabetic vascular disease, arteriovenous fistula, etc.  Venous disease is divided into superficial venous disease and deep venous disease, superficial venous disease includes varicose veins and thrombotic superficial phlebitis; deep venous disease includes deep venous thrombosis, primary deep venous valve insufficiency, deep venous thrombosis can cause pulmonary embolism (can be fatal), secondary deep venous thrombosis after syndrome; also includes Buga syndrome, K-T syndrome, etc.  Lymphatic system diseases are mainly inflammatory and reflux obstructive diseases, such as lymphangitis, dengue, and lymphoma.  Most of the vascular diseases are of a more harmful nature. Such as aneurysm rupture and bleeding, pulmonary embolism can lead to sudden death; multiple aortitis, Buga’s disease, arteriovenous fistula, nodular polyarteritis can lead to important organ failure and death; atherosclerosis occlusive disease, arterial embolism, diabetic gangrene, etc. can occur gangrene of the limb, so that to save life had to do amputation and cause disability; venous and lymphatic diseases, except pulmonary embolism and Buga’s syndrome can endanger In addition, venous and lymphatic reflux disorders and venous valve insufficiency can cause perennial lower limb swelling, calf pigmentation, pruritus and ulcers. These diseases leave patients in a “semi-disabled” state, which seriously affects people’s quality of life.  The treatment of vascular disease is broadly divided into two parts, namely surgical treatment and interventional treatment.  The indications for drug treatment are venous thrombosis, chronic blood supply deficiency and arterial spasm disease, including thrombolysis, anticoagulation, expectoration, vasodilation, fibrinogenesis and inhibition of platelet adhesion aggregation and other drugs. Commonly used western drugs include urokinase, heparin, low molecular dextran, ketococaine, thrombin, prostaglandin E, aspirin, and resorcinol, etc.  Surgical treatment is an important part of peripheral vascular disease treatment, including peripheral vascular injury requiring vascular anastomosis and repair, vascular bypass surgery, venous valve repair and amputation surgery, etc. In combination with drug treatment, it can shorten the course of treatment, improve the efficacy, reduce the rate of disability, amputation and mortality.  Interventional vascular therapy is a new treatment method developed in the past decade or so, which has led to a dramatic change in the treatment mode of vascular surgery diseases. Compared with traditional surgical procedures, interventional procedures have the advantages of less injury, lower complication and mortality rates, and faster patient recovery. For example, percutaneous balloon angioplasty (PTA), endoluminal vascular stent implantation, vascular embolization and thrombolysis have been widely used in the treatment of arterial dilatation, arterial obstructive diseases, arteriovenous fistulas and some venous diseases.